A PROSPECTIVE STUDY OF RESULTS OF MESH HERNIOPLASTY AND MODIFIED DARNING IN PRIMARY INGUINAL HERNIA

Abstract

INTRODUCTION: Hernia may be generally dened as a protrusion of abdominal viscera or a part of viscera outside the abdominal cavity through a natural or acquired defect. This denition, however, does not includeinternal hernias in which abdominal viscera, usually the small bowel, enter preformed intraperitoneal sacs commonly found around the duodenum, cecum, and sigmoid colon. AIMS AND OBJECTIVES: Inguinal hernia is one of the commonest surgical operations performed. There are many ways of repairing an inguinal hernia. Various techniques claim superiority over one another. The preferred method of inguinal hernia repair at all centres, particularly training institutes, utilize mesh because recurrence rates are low. However, it is shown that the less costly technique of “Darning” has the same incidence of complications and recurrence. This emphasizes the importance of training and supervision no matter which technique is employed. MATERIALS AND METHODS: Synthetic Non absorbable monolament material like polypropylene mesh andProlinne 2-0 Suture inGroin hernia repair. Patients with Groin hernia attending at OPD of SSKM Hospital and. CNMC&H, Kolkata, West Bengal. In SSKM Hospital-MARCH 2017 – SEPTEMBER 2018 and CNMC&H OCTOBER 2018- MARCH 2021, N=200 (n=100 in each group.) Randomized prospective parallel group study. RESULTS AND ANALYSIS: In proline darning, 8 patients had neuralgia Complications after hernia repair-( late>7 days) and 4 patients had scar tenderness Complications after hernia repair- (late >7 days) . In our study,72(72%) patients had Proline darning RIH Diagnosis, 4(4%) patients had Proline darning BLIH Diagnosis and 24(24%) patients had Proline darning LIH Diagnosis. SUMMARY: Thus the above study shows that there is no signicant difference between mesh/darn method of repair of primary inguinal hernia in terms of postoperative complications, duration of hospital stay, time of surgery, day off work provided necessary surgical skill, patient compliance, facilities are available. Though darning requires expertise in maintaining no tension during surgery, with little experience one can perform it with case and results similar to mesh repair. It is the cheaper and effective alternative to mesh repair in remote areas where availability of mesh and other facilities are difcult. CONCLUSION: So endogenous tissue is always superior to any foreign material once the mesh becomes infected it becomes resistant to healing and present with persistent sinus or stula or abscess. Source control is the applied histology of any inammatory process. Its foundation lies in the optimal harnessing off the process of inammation and tissue repair to expedite the resolution of infection. Endomesh created by using the endogenous tissue, internal oblique and transversusabdominis muscle and the use of redundanthernial sac is the future of herniorrhaphy operation.